Because of the Affordable Care Act (ACA), most insurance plans are very similar. They’re grouped into five levels – catastrophic, bronze, silver, gold and platinum. You can go to the Health Insurance Marketplace to compare health insurance plans at every level from every company. Chances are, the features and price are very much the same.
That’s when it’s good to know the important differences between health insurance companies. Here are a couple of questions to answer when you compare health insurance companies in Wisconsin.
- Is the company “Provider-Owned”?
Health insurance companies that are provider-owned are part of a local or regional health care system. Their role as part of the system is to help their members get the care they need locally, within the system, if that best serves the member. Members benefit by having guaranteed access to leading local facilities, doctors and specialists. The focus of the health insurance company is not to deny coverage, but rather, to help members get the care they’re entitled to.
- What clinics, hospitals, doctors and specialists belong to the provider network?
Health insurance companies contract with health care providers throughout a specific area. This is called the provider network. It’s important to review what providers participate in each network to make sure the hospitals, specialists and clinics you may need are available to you. For example, if you live in south central Wisconsin and have children, you’ll likely want to make sure that the American Family Children’s Hospital is part of your provider network. Check out Unity’s provider networks.
- Does the health insurance company participate in national quality programs?
The National Committee for Quality Assurance (NCQA) accredits health plans across the nation and publicly posts Health Insurance Plan Ratings. Health insurance companies in Wisconsin are not required to participate. Companies that commit to the high quality standards needed for accreditation demonstrate that they place high importance on quality of their plan and of the providers they work with.
- Does the company post customer satisfaction metrics online?
Health insurance companies that focus on maintaining high levels of customer satisfaction track, measure and work to continually improve customer service. Some go the extra mile by posting these results on their website.